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Pathology - Penile disorders
Lichen sclerosus • Penile lichen sclerosus (balanitis xerotica obliterans) is an inflammatory condition mostly affecting the foreskin or glans penis. • The majority of cases manifest in adulthood with phimosis. • Macroscopically, the impacted regions have a whitish and atrophic appearance. • Histologically, there is epidermal atrophy and hyperkeratosis accompanied by underlying bands of hyalinized collagen and a persistent inflammatory cell infiltrate.
Lichen planus • Penile involvement frequently occurs in patients with widespread lichen planus (see p. 288). • The lesions frequently affect the glans penis. • Histological examination reveals a band-like inflammatory infiltrate next to the epithelium. The infiltrate frequently comprises plasma cells, whereas cutaneous lesions are predominantly characterized by lymphocytes and macrophages.
Zoon's balanitis typically manifests as a singular erythematous lesion in uncircumcised older males. It clinically resembles penile Bowen's disease. Histological examination reveals epidermal thinning, spongiosis, lozenge-shaped keratinocytes, and a dense band-like inflammatory infiltrate abundant in plasma cells.
Condylomas are induced by an infection with the human papillomavirus (HPV), typically types 6 and 11. Predominantly observed in sexually active young males. • Macroscopically, condylomas manifest as either flat or frond-like papillary excrescences. • Histologically, they exhibit a papillomatous squamous proliferation characterized by koilocytes (keratinocytes exhibiting HPV-induced cytopathic alterations).
Peyronie's disease • Commonly referred to as penile fibromatosis, albeit likely not associated with other kinds of fibromatosis (see p. 318). • Individuals aged 40–60 have thickening of the corpus cavernosa, resulting in penile discomfort and curvature during erection. • Histological analysis of excised tissue reveals hypocellular collagenous scar tissue accompanied by clusters of chronic inflammatory cells.
Penile cancer • Uncommon neoplasm that typically develops on the glans penis of older males. Risk factors including HPV infection, tobacco use, phimosis, and chronic lichen sclerosus. Circumcision correlates with a decreased risk. Macroscopically, they present as exophytic lumps that may undergo ulceration. The majority are histologically classified as squamous cell carcinomas, originating from regions of squamous dysplasia, occasionally referred to as penile intraepithelial neoplasia.
Lichen sclerosus • Penile lichen sclerosus (balanitis xerotica obliterans) is an inflammatory condition mostly affecting the foreskin or glans penis. • The majority of cases manifest in adulthood with phimosis. • Macroscopically, the impacted regions have a whitish and atrophic appearance. • Histologically, there is epidermal atrophy and hyperkeratosis accompanied by underlying bands of hyalinized collagen and a persistent inflammatory cell infiltrate.
Lichen planus • Penile involvement frequently occurs in patients with widespread lichen planus (see p. 288). • The lesions frequently affect the glans penis. • Histological examination reveals a band-like inflammatory infiltrate next to the epithelium. The infiltrate frequently comprises plasma cells, whereas cutaneous lesions are predominantly characterized by lymphocytes and macrophages.
Zoon's balanitis typically manifests as a singular erythematous lesion in uncircumcised older males. It clinically resembles penile Bowen's disease. Histological examination reveals epidermal thinning, spongiosis, lozenge-shaped keratinocytes, and a dense band-like inflammatory infiltrate abundant in plasma cells.
Condylomas are induced by an infection with the human papillomavirus (HPV), typically types 6 and 11. Predominantly observed in sexually active young males. • Macroscopically, condylomas manifest as either flat or frond-like papillary excrescences. • Histologically, they exhibit a papillomatous squamous proliferation characterized by koilocytes (keratinocytes exhibiting HPV-induced cytopathic alterations).
Peyronie's disease • Commonly referred to as penile fibromatosis, albeit likely not associated with other kinds of fibromatosis (see p. 318). • Individuals aged 40–60 have thickening of the corpus cavernosa, resulting in penile discomfort and curvature during erection. • Histological analysis of excised tissue reveals hypocellular collagenous scar tissue accompanied by clusters of chronic inflammatory cells.
Penile cancer • Uncommon neoplasm that typically develops on the glans penis of older males. Risk factors including HPV infection, tobacco use, phimosis, and chronic lichen sclerosus. Circumcision correlates with a decreased risk. Macroscopically, they present as exophytic lumps that may undergo ulceration. The majority are histologically classified as squamous cell carcinomas, originating from regions of squamous dysplasia, occasionally referred to as penile intraepithelial neoplasia.
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